New research has revealed a link between a lesser known heart syndrome and COVID infection, with a much smaller link seen between the condition and COVID vaccination.
Postural orthostatic tachycardia syndrome (POTS) is a nervous system-related condition that causes a rapid increase in the heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of standing. Some experience fainting, dizziness, fatigue, migraine, increased urination, sweaty extremities, anxiety and tremor.
While vaccination posed some level of risk, people diagnosed with COVID-19 were five times more likely to develop POTS than after vaccination.
"The main message here is that while we see a potential link between COVID-19 vaccination and POTS, preventing COVID-19 through vaccination is still the best way to reduce your risk of developing POTS," said first author Dr. Alan Kwan, a cardiovascular specialist at Cedars-Sinai Medical Center in Los Angeles.
"From this analysis, we found that the odds of developing POTS are higher 90 days after vaccine exposure than the 90 days prior to exposure," Kwan said in a center news release. "We also found that the relative odds of POTS were higher than would be explained by increases in visits to physicians after vaccination or infection.
"This knowledge identifies a possible -- yet still relatively slim -- association between COVID-19 vaccination and POTS," Kwan said.
The research team used data from more than 284,000 vaccinated patients treated within the broader Cedars-Sinai Health System between 2020 and 2022, along with more than 12,000 Cedars-Sinai patients with COVID-19.
Many health care providers are unfamiliar with POTS and its symptoms, which has caused patients to struggle for years before getting a proper diagnosis. Symptoms of POTS are sometimes incorrectly attributed to chronic fatigue syndrome or other conditions.
With the connection to the COVID virus, the medical field has come to better understand POTS.
"In an unexpected but important way, the COVID-19 pandemic brought a great deal of awareness to POTS -- both to patients and providers," said co-author Dr. Peng-Sheng Chen, a Cedars-Sinai expert on the condition who leads one of only a few POTS specialty clinics in the nation.
"Given a broader understanding of the disease, many patients can be diagnosed more quickly permitting earlier interventions that can greatly improve their symptoms," Chen said in the release.
POTS typically affects young women of childbearing age.
POTS interventions include avoiding triggers such as prolonged standing, extreme heat, extreme cold and alcoholic beverages, Chen said. Patients with the condition may also be advised to eat a high-sodium diet and wear abdominal or lower-body compression garments. Sometimes patients are treated with specific medications or programs to strengthen the body and heart.
The study has limitations, researchers said, but they hope it will help improve conversations around COVID-19 and vaccines.
"We recognize as clinicians that side effects from vaccines can vary in type and severity, even if still uncommon overall. We hope that clearer data and improved understanding will eventually enhance medical trust and quality of care as well as communications around vaccines," Kwan said. "Ultimately, our goal is to optimize vaccine uptake."
The findings were published Dec. 12 in the journal Nature Cardiovascular Research.
The U.S. National Institute of Neurological Disorders and Stroke has more on POTS.
SOURCE: Cedars-Sinai Medical Center, news release, Dec. 12, 2022